| NPI | 1316466774 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 66127) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 66127) |
| 207R00000X Internal Medicine (Licence: MN 28356) | |
| Enumeration Date | 2017-09-16 |
| Last Update Date | 2025-01-31 |